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Puiggros A, Collado R, Calasanz MJ, Ortega M, Ruiz-Xivillé N, Rivas-Delgado A, Luño E, González T, Navarro B, García-Malo M, Valiente A, Hernández JÁ, Ardanaz MT, Piñan MÁ, Blanco ML, Hernández-Sánchez M, Batlle-López A, Salgado R, Salido M, Ferrer A, Abrisqueta P, Gimeno E, Abella E, Ferrá C, Terol MJ, Ortuño F, Costa D, Moreno C, Carbonell F, Bosch F, Delgado J, Espinet B. Patients with chronic lymphocytic leukemia and complex karyotype show an adverse outcome even in absence of TP53/ATM FISH deletions. Oncotarget 2017; 8:54297-54303. [PMID: 28903342 PMCID: PMC5589581 DOI: 10.18632/oncotarget.17350] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/11/2017] [Indexed: 11/25/2022] Open
Abstract
Genomic complexity identified by chromosome banding analysis (CBA) predicts a worse clinical outcome in CLL patients treated either with standard or new treatments. Herein, we analyzed the clinical impact of complex karyotypes (CK) with or without high-risk FISH deletions (ATM and/or TP53, HR-FISH) in a cohort of 1045 untreated MBL/CLL patients. In all, 99/1045 (9.5%) patients displayed a CK. Despite ATM and TP53 deletions were more common in CK (25% vs 7%; P < 0.001; 40% vs 5%; P < 0.001, respectively), only 44% (40/90) patients with TP53 deletions showed a CK. CK group showed a significant higher two-year cumulative incidence of treatment (48% vs 20%; P < 0.001), as well as a shorter overall survival (OS) (79 mo vs not reached; P < 0.001). When patients were categorized regarding CK and HR-FISH, those with both characteristics showed the worst median OS (52 mo) being clearly distinct from those non-CK and non-HR-FISH (median not reached), but no significant differences were detected between cases with only CK or HR-FISH. Both CK and TP53 deletion remained statistically significant in the multivariate analysis for OS. In conclusion, CK group is globally associated with advanced disease and poor prognostic markers. Further investigation in larger cohorts with CK lacking HR-FISH is needed to elucidate which mechanisms underlie the poor outcome of this subgroup.
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Costa D, Nomdedeu M, Pereira A, Calvo X, Colomer J, Soler F, Luno E, Cervera J, Arnan M, Ramos F, Oiartzabal I, Arrizabalaga B, Tormo M, Diez-campelo M, Ortega M, Collado R, Granada I, Sanz G, Campo E, Esteve J. Clinical and Biological Significance of Y Chromosome Loss in a Series of 2,423 Male Patients with MDS and CMML. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30321-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Triguero A, Xicoy B, Jiménez M, García O, Ramos F, Calabuig M, Liang T, Arzuaga J, Díaz-Beyá M, Medina Á, Bernal T, Brunet S, Coll R, Collado R, Borrás J, Talarn C, Sanz G. Response to Azacitidine in a Series of 94 Patients with Chronic Myelomonocytic Leukemia from the Spanish Group of Myelodysplastic Syndromes. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30232-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Javier K, Orero M, Costa S, Ortiz S, Villegas C, Collado R. Prognostic Impact of Who 2016 Classification of Chronic Myelomonocytic Leukemia. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30187-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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García-Gutiérrez V, Gómez-Casares MT, Puerta JM, Alonso-Domínguez JM, Osorio S, Hernández-Boluda JC, Collado R, Ramírez MJ, Ibáñez F, Martín ML, Rodríguez-Gambarte JD, Martínez-Laperche C, Gómez M, Fiallo DV, Redondo S, Rodríguez A, Ruiz-Nuño C, Steegmann JL, Jiménez-Velasco A. A BCR-ABL1 cutoff of 1.5% at 3 months, determined by the GeneXpert system, predicts an optimal response in patients with chronic myeloid leukemia. PLoS One 2017; 12:e0173532. [PMID: 28278193 PMCID: PMC5344481 DOI: 10.1371/journal.pone.0173532] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 02/21/2017] [Indexed: 11/18/2022] Open
Abstract
In chronic myeloid leukemia (CML) patients, 3-month BCR-ABL1 levels have consistently been correlated with further outcomes. Monitoring molecular responses in CML using the GeneXpert (Cepheid) platform has shown an optimal correlation with standardized RQ-PCR (IS) when measuring BCR-ABL1 levels lower than 10%, as it is not accurate for values over 10%. The aim of the present study was to determine the predictive molecular value at three months on different outcome variables using the Xpert BCR-ABL1 MonitorTM assay (Xpert BCR-ABL1). We monitored 125 newly diagnosed consecutive CML patients in the chronic phase (CML-CP) using an automated method: Xpert BCR-ABL1. Only 5% of patients did not achieve an optimal response at 3 months, and the 10% BCR-ABL1 cutoff defined by RQ-PCR (IS) methods was unable to identify significant differences in the probabilities of achieving a complete cytogenetic response (CCyR) (50% vs. 87%, p = 0.1) or a major molecular response (MMR) (60% vs. 80%, p = 0.29) by 12 months. In contrast, a cutoff of 1.5% more accurately identified differences in the probabilities of achieving CCyR (98% vs. 54%, p<0.001) and MMR (88% vs. 56%, p<0.001) by 12 months, as well as probabilities of treatment changes (p = 0.005). Therefore, when using the Xpert BCR-ABL1 assay, a cutoff of 1.5% at 3 months could with high probability identify patients able to achieve an optimal response at 12 months.
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MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/genetics
- Cohort Studies
- Female
- Follow-Up Studies
- Fusion Proteins, bcr-abl/genetics
- Gene Rearrangement
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Male
- Middle Aged
- Neoplasm Staging
- Polymerase Chain Reaction/methods
- Prognosis
- Protein Kinase Inhibitors/therapeutic use
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Nomdedeu M, Pereira A, Ramos F, Valcárcel D, Costa D, Arnan M, Calvo X, Pomares H, Luño E, Díaz-Campelo M, Collado R, de Paz R, Falantes JF, Pedro C, Marco J, Oirtzabal I, Sánchez-García J, Tormo M, Cedena MT, Nomdedeu B, Sanz G. Excess mortality in the myelodysplastic syndromes. Am J Hematol 2017; 92:149-154. [PMID: 27859564 DOI: 10.1002/ajh.24606] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 11/10/2022]
Abstract
Myelodysplastic syndromes (MDS) are the commonest hematologic malignancies in the elderly. Since many patients with MDS actually die from age-related ailments, the very disease burden of MDS remains largely unknown. This registry-based study was aimed at investigating the excess mortality attributable to MDS. We analyzed 7,408 adult patients diagnosed with primary MDS from 1980 to 2014. Excess mortality was estimated by comparing the patients' survival with that expected in the matched general population. Median age of patients was 74 years, 58% were males, and 65% belonged to the lower risk categories of the Revised International Prognostic Scoring System (IPSS-R). Excess mortality accounted for three-fourths of the all-cause mortality and was mainly driven by factors unrelated to leukemic transformation. Excess mortality increased with the IPSS-R risk category [Incidence rate ratio (IRR): 2.1, 95% CI: 1.9-2.3; P < .001]. Older age and male sex retained an independent association with higher excess mortality after discounting demographic effects. Excess mortality increased in the most recent periods just in the higher risk IPSS-R categories (IRR: 1.2; 95% CI: 1.1-1.3 when comparing periods 2007-14, 2000-06, and 1980-99). In conclusion, MDS carry a significant excess mortality, even in the lower risk categories, that is mainly driven by factors unrelated to leukemic transformation, and increases with older age, male sex, and poorer risk categories. Excess mortality has increased in recent years in the higher risk patients, which might be ascribed to a parallel increase in age-related comorbidities. Our results claim for more comprehensive treatment strategies for patients with MDS. Am. J. Hematol. 92:149-154, 2017. © 2016 Wiley Periodicals, Inc.
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Baliakas P, Puiggros A, Xochelli A, Sutton LA, Nguyen-Khac F, Gardiner A, Plevova K, Minga E, Hadzidimitriou A, Walewska R, McCarthy H, Ortega M, Collado R, González T, Granada I, Luño E, Kotašková J, Moysiadis T, Davis Z, Stavroyianni N, Anagnostopoulos A, Strefford JC, Pospisilova S, Davi F, Athanasiadou A, Rosenquist R, Oscier D, Espinet B, Stamatopoulos K. Additional trisomies amongst patients with chronic lymphocytic leukemia carrying trisomy 12: the accompanying chromosome makes a difference. Haematologica 2016; 101:e299-302. [PMID: 27102498 DOI: 10.3324/haematol.2015.140202] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Nomdedeu M, Calvo X, Pereira A, Carrió A, Solé F, Luño E, Cervera J, Vallespí T, Muñoz C, Gómez C, Arias A, Such E, Sanz G, Grau J, Insunza A, Calasanz MJ, Ardanaz MT, Hernández-Rivas JM, Azaceta G, Álvarez S, Sánchez J, Martín ML, Bargay J, Gómez V, Cervero CJ, Allegue MJ, Collado R, Campo E, Esteve J, Nomdedeu B, Costa D. Prognostic impact of chromosomal translocations in myelodysplastic syndromes and chronic myelomonocytic leukemia patients. A study by the spanish group of myelodysplastic syndromes. Genes Chromosomes Cancer 2015; 55:322-7. [DOI: 10.1002/gcc.22333] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 10/28/2015] [Accepted: 10/29/2015] [Indexed: 11/11/2022] Open
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Hernández JÁ, Hernández-Sánchez M, Rodríguez-Vicente AE, Grossmann V, Collado R, Heras C, Puiggros A, Martín AÁ, Puig N, Benito R, Robledo C, Delgado J, González T, Queizán JA, Galende J, de la Fuente I, Martín-Núñez G, Alonso JM, Abrisqueta P, Luño E, Marugán I, González-Gascón I, Bosch F, Kohlmann A, González M, Espinet B, Hernández-Rivas JM. A Low Frequency of Losses in 11q Chromosome Is Associated with Better Outcome and Lower Rate of Genomic Mutations in Patients with Chronic Lymphocytic Leukemia. PLoS One 2015; 10:e0143073. [PMID: 26630574 PMCID: PMC4667902 DOI: 10.1371/journal.pone.0143073] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/30/2015] [Indexed: 12/11/2022] Open
Abstract
To analyze the impact of the 11q deleted (11q-) cells in CLL patients on the time to first therapy (TFT) and overall survival (OS), 2,493 patients with CLL were studied. 242 patients (9.7%) had 11q-. Fluorescence in situ hybridization (FISH) studies showed a threshold of 40% of deleted cells to be optimal for showing that clinical differences in terms of TFT and OS within 11q- CLLs. In patients with ≥40% of losses in 11q (11q-H) (74%), the median TFT was 19 months compared with 44 months in CLL patients with <40% del(11q) (11q-L) (P<0.0001). In the multivariate analysis, only the presence of 11q-L, mutated IGHV status, early Binet stage and absence of extended lymphadenopathy were associated with longer TFT. Patients with 11q-H had an OS of 90 months, while in the 11q-L group the OS was not reached (P = 0.008). The absence of splenomegaly (P = 0.02), low LDH (P = 0.018) or β2M (P = 0.006), and the presence of 11q-L (P = 0.003) were associated with a longer OS. In addition, to detect the presence of mutations in the ATM, TP53, NOTCH1, SF3B1, MYD88, FBXW7, XPO1 and BIRC3 genes, a select cohort of CLL patients with losses in 11q was sequenced by next-generation sequencing of amplicons. Eighty % of CLLs with 11q- showed mutations and fewer patients with low frequencies of 11q- had mutations among genes examined (50% vs 94.1%, P = 0.023). In summary, CLL patients with <40% of 11q- had a long TFT and OS that could be associated with the presence of fewer mutated genes.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Chromosome Deletion
- Chromosomes, Human, Pair 11
- Female
- Gene Expression
- High-Throughput Nucleotide Sequencing
- Humans
- Immunoglobulin Heavy Chains/genetics
- In Situ Hybridization, Fluorescence
- Karyotype
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Middle Aged
- Mutation
- Neoplasm Proteins/genetics
- Neoplasm Proteins/immunology
- Prognosis
- Retrospective Studies
- Survival Analysis
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Macías M, Zornoza C, Rodriguez E, García JA, Fernández JA, Luque R, Collado R. Impact of Hospital Admission Care At a Pediatric Unit: A Qualitative Study. PEDIATRIC NURSING 2015; 41:285-294. [PMID: 26837098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The time of admission to a hospital, especially when unplanned, has been reported as the most stressful moment of hospitalization for both parents and children (Odievre, 2001). This qualitative study explored parents and hospital staff's perceptions and experiences related to the process of admission to a pediatric unit. Focus groups, two with parents (total n = 12) and one with health care professionals (n = 6), were conducted, and content analysis inspired by Graneheim and Lundman (2004) was performed. Parents identified four categories of perceptions: 1) management of an uncertain situation at the time of admission, 2) feelings related to the child's illness, 3) parent perception of professional's performance, and 4) parent experience of their role. Health care professionals identified two categories: 1) hospital admission as a continuous care process, and 2) undertaking improvements in the admission process. A common theme emerged about the importance of parents' trust in professionals in order to build a therapeutic relationship. Findings underscore the need for strategies to improve the hospital pediatric admission process based on a parent-professional relationship of trust and confidence through continuous quality communication and support. These strategies would include providing a nurse in charge of the admission process to assure continuity of care throughout the child's hospitalization.
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Xicoy B, Germing U, Jimenez MJ, Garcia O, Garcia R, Schemenau J, Pedro C, Luño E, Bernal T, González B, Strupp C, Ardanaz M, Kuendgen A, Cedena MT, Neukirchen J, Calabuig M, Brunet S, Medina A, Amigo ML, Ramos F, Callejas M, Díez-Campelo M, Bailén A, Collado R, Vicente A, Arnan M, Valcarcel D, Arilla MJ, Zamora L, Benlloch L, Sanz G. Response to erythropoietic-stimulating agents in patients with chronic myelomonocytic leukemia. Eur J Haematol 2015; 97:33-8. [DOI: 10.1111/ejh.12679] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2015] [Indexed: 12/29/2022]
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37
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Valcárcel D, Sanz G, Ortega M, Nomdedeu B, Luño E, Diez-Campelo M, Ardanaz MT, Pedro C, Montoro J, Collado R, Andreu R, Marco V, Cedena MT, de Paz R, Tormo M, Xicoy B, Ramos F, Bargay J, Gonzalez B, Brunet S, Muñoz JA, Gomez V, Bailén A, Sanchez J, Merchán B, del Cañizo C, Vallespí T. Use of newer prognostic indices for patients with myelodysplastic syndromes in the low and intermediate-1 risk categories: a population-based study. LANCET HAEMATOLOGY 2015; 2:e260-6. [DOI: 10.1016/s2352-3026(15)00067-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 03/23/2015] [Accepted: 03/24/2015] [Indexed: 10/23/2022]
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Xicoy B, Such E, Garcia O, Jimenez M, Arnan M, Bernal T, Nomdedeu B, Valcárcel D, Pedro C, Ramos F, Amigo M, Collado R, Palomo L, Ardanaz M, Calabuig M, Cedena M, Grau J, Sanz G. 83 PERCENTAGE OF BLASTS IN CHRONIC MYELOMONOCYTIC LEUKEMIA TYPE-1 HAS NO IMPACT ON OVERALL SURVIVAL IN A SERIES OF PATIENTS FROM THE SPANISH REGISTRY OF MDS. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30084-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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39
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del Rey M, Janusz K, Abáigar M, Collado R, Ivars D, Valiente A, Hernández M, Díez-Campelo M, Ramos F, Sánchez-Real J, del Cañizo C, Hernández-Rivas J. 171 A TWO-STEP APPROACH FOR THE ANALYSIS OF SPLICING GENES IN MYELODYSPLASTIC SYNDROMES WITH RING SIDEROBLASTS. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30172-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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40
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Adema V, Larráyoz MJ, Calasanz MJ, Palomo L, Patiño-García A, Agirre X, Hernández-Rivas JM, Lumbreras E, Buño I, Martinez-Laperche C, Mallo M, García O, Álvarez S, Blazquez B, Cervera J, Luño E, Valiente A, Vallespí MT, Arenillas L, Collado R, Pérez-Oteyza J, Solé F. Correlation of myelodysplastic syndromes with i(17)(q10) and TP53 and SETBP1 mutations. Br J Haematol 2015; 171:137-41. [PMID: 25716545 DOI: 10.1111/bjh.13355] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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41
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González-Gascón y Marín I, Hernández-Sánchez M, Rodríguez-Vicente AE, Sanzo C, Aventín A, Puiggros A, Collado R, Heras C, Muñoz C, Delgado J, Ortega M, González MT, Marugán I, de la Fuente I, Recio I, Bosch F, Espinet B, González M, Hernández-Rivas JM, Hernández JÁ. A high proportion of cells carrying trisomy 12 is associated with a worse outcome in patients with chronic lymphocytic leukemia. Hematol Oncol 2015; 34:84-92. [DOI: 10.1002/hon.2196] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 01/19/2015] [Accepted: 01/21/2015] [Indexed: 11/10/2022]
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Lozano-Santos C, Martinez-Velasquez J, Fernandez-Cuevas B, Polo N, Navarro B, Millan I, Garcia JM, Collado R, Sanchez-Godoy P, Carbonell F, Garcia-Vela JA, Garcia-Marco JA, Gomez-Lozano N. Vascular endothelial growth factor A (VEGFA) gene polymorphisms have an impact on survival in a subgroup of indolent patients with chronic lymphocytic leukemia. PLoS One 2014; 9:e101063. [PMID: 24971577 PMCID: PMC4074164 DOI: 10.1371/journal.pone.0101063] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 06/03/2014] [Indexed: 12/13/2022] Open
Abstract
Vascular endothelial growth factor (VEGF)-mediated angiogenesis contributes to the pathogenesis of B-cell chronic lymphocytic leukaemia (CLL). We investigated the impact of VEGFA gene diversity on the clinical outcome of patients with this disease. A VEGFA haplotype conformed by positions rs699947 (–1540C>A), rs833061 (–460T>C) and rs2010963 (405C>G) and two additional single-nucleotide polymorphisms (SNPs), rs3025039 (936C>T) and rs25648 (1032C>T), were analysed in 239 patients at the time of their CLL diagnosis. Here, we showed that homozygosity for rs699947/rs833061/rs2010963 ACG haplotype (ACG+/+ genotype) correlated with a reduced survival in CLL patients (ACG+/+ vs other genotypes: HR = 2.3, p = 0.002; recessive model). In multivariate analysis, the ACG+/+ genotype was identified as a novel independent prognostic factor (HR = 2.1, p = 0.005). Moreover, ACG homozygosity subdivided patients with CLL with otherwise indolent parameters into prognostic subgroups with different outcomes. Specifically, patients carrying the ACG+/+ genotype with mutated IgVH, very low and low-risk cytogenetics, initial clinical stage, CD38 negative status or early age at diagnosis showed a shorter survival (ACG+/+ vs other genotypes: HR = 3.5, p = 0.035; HR = 3.4, p = 0.001; HR = 2.2, p = 0.035; HR = 3.4, p = 0.0001 and HR = 3.1, p = 0.009, respectively). In conclusion, VEGFA ACG+/+ genotype confers an adverse effect in overall survival in CLL patients with an indolent course of the disease. These observations support the biological and prognostic implications of VEGFA genetics in CLL.
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Collado R, Ivars D, Oliver I, Tormos C, Egea M, Miguel A, Sáez GT, Carbonell F. Increased oxidative damage associated with unfavorable cytogenetic subgroups in chronic lymphocytic leukemia. BIOMED RESEARCH INTERNATIONAL 2014; 2014:686392. [PMID: 25054143 PMCID: PMC4099055 DOI: 10.1155/2014/686392] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 05/30/2014] [Accepted: 06/11/2014] [Indexed: 12/12/2022]
Abstract
Oxidative stress contributes to genomic instability in chronic lymphocytic leukemia (CLL), but its relationship with the acquisition of specific chromosomal abnormalities is unknown. We recruited 55 untreated CLL patients and assessed 8-oxo-2'-deoxyguanosine (8-oxo-dG), glutathione, and malondialdehyde (MDA) levels, and we compared them among the cytogenetic subgroups established using fluorescence in situ hybridization (FISH). Significant increases in 8-oxo-dG and/or MDA were observed in patients with unfavorable cytogenetic aberrations (17p and 11q deletions) compared to the 13q deletion group. TP53 deletion patients exhibited a diminished DNA repair efficiency. Finally, cases with normal FISH also showed enhanced 8-oxo-dG, which could result in adverse outcomes.
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Puiggros A, Venturas M, Salido M, Blanco G, Fernandez-Rodriguez C, Collado R, Valiente A, Ruiz-Xivillé N, Carrió A, Ortuño FJ, Luño E, Calasanz MJ, Ardanaz MT, Piñán MÁ, Talavera E, González MT, Ortega M, Marugán I, Ferrer A, Gimeno E, Bellosillo B, Delgado J, Hernández JÁ, Hernández-Rivas JM, Espinet B. Interstitial 13q14 deletions detected in the karyotype and translocations with concomitant deletion at 13q14 in chronic lymphocytic leukemia: different genetic mechanisms but equivalent poorer clinical outcome. Genes Chromosomes Cancer 2014; 53:788-97. [PMID: 24915757 DOI: 10.1002/gcc.22188] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 05/22/2014] [Accepted: 05/23/2014] [Indexed: 01/21/2023] Open
Abstract
Deletion of 13q14 as the sole abnormality is a good prognostic marker in chronic lymphocytic leukemia (CLL). Nonetheless, the prognostic value of reciprocal 13q14 translocations [t(13q)] with related 13q losses has not been fully elucidated. We described clinical and biological characteristics of 25 CLL patients with t(13q), and compared with 62 patients carrying interstitial del(13q) by conventional G-banding cytogenetics (CGC) [i-del(13q)] and 295 patients with del(13q) only detected by fluorescence in situ hybridization (FISH) [F-del(13q)]. Besides from the CLL FISH panel (D13S319, CEP12, ATM, TP53), we studied RB1 deletions in all t(13q) cases and a representative group of i-del(13q) and F-del(13q). We analyzed NOTCH1, SF3B1, and MYD88 mutations in t(13q) cases by Sanger sequencing. In all, 25 distinct t(13q) were described. All these cases showed D13S319 deletion while 32% also lost RB1. The median percentage of 13q-deleted nuclei did not differ from i-del(13q) patients (73% vs. 64%), but both were significantly higher than F-del(13q) (52%, P < 0.001). Moreover, t(13q) patients showed an increased incidence of biallelic del(13q) (52% vs. 11.3% and 14.9%, P < 0.001) and higher rates of concomitant 17p deletion (37.5% vs. 8.6% and 7.2%, P < 0.001). RB1 involvement was significantly higher in the i-del(13q) group (79%, P < 0.001). Two t(13q) patients (11.8%) carried NOTCH1 mutations. Time to first treatment in t(13q) and i-del(13q) was shorter than F-del(13q) (67, 44, and 137 months, P = 0.029), and preserved significance in the multivariate analysis. In conclusion, t(13q) and del(13q) patients detected by CGC constitute a subgroup within the 13q-deleted CLL patients associated with a worse clinical outcome.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Chromosome Aberrations
- Chromosome Deletion
- Chromosomes, Human, Pair 13/genetics
- Cohort Studies
- Female
- Humans
- Karyotype
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Middle Aged
- Myeloid Differentiation Factor 88/genetics
- Phosphoproteins/genetics
- Prognosis
- RNA Splicing Factors
- Receptor, Notch1/genetics
- Retinoblastoma Protein/genetics
- Ribonucleoprotein, U2 Small Nuclear/genetics
- Translocation, Genetic
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Saumell S, Florensa L, Rodríguez-Rivera M, Pedro C, Hernández-Rivas JM, Lumbreras E, Abáigar M, Collado R, Ivars D, Carbonell F, Marugán I, Tormo M, Botia M, Piñan MÁ, Ancín I, González T, Varela ND, Grau J, Granada I, Ruiz N, Martín ML, Fernández-Guijarro M, Duarte JJ, Calasanz MJ, Larrayoz MJ, Solé F. Fluorescence in situ hybridization analysis does not increase detection rate for trisomy 8 in chronic myelomonocytic leukemia. Leuk Lymphoma 2014; 56:242-3. [PMID: 24724779 DOI: 10.3109/10428194.2014.914197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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46
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Espinet B, Ferrer A, Bellosillo B, Nonell L, Salar A, Fernández-Rodríguez C, Puigdecanet E, Gimeno J, Garcia-Garcia M, Vela MC, Luño E, Collado R, Navarro JT, de la Banda E, Abrisqueta P, Arenillas L, Serrano C, Lloreta J, Miñana B, Cerutti A, Florensa L, Orfao A, Sanz F, Solé F, Dominguez-Sola D, Serrano S. Distinction between asymptomatic monoclonal B-cell lymphocytosis with cyclin D1 overexpression and mantle cell lymphoma: from molecular profiling to flow cytometry. Clin Cancer Res 2013; 20:1007-19. [PMID: 24352646 DOI: 10.1158/1078-0432.ccr-13-1077] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE According to current diagnostic criteria, mantle cell lymphoma (MCL) encompasses the usual, aggressive variants and rare, nonnodal cases with monoclonal asymptomatic lymphocytosis, cyclin D1-positive (MALD1). We aimed to understand the biology behind this clinical heterogeneity and to identify markers for adequate identification of MALD1 cases. EXPERIMENTAL DESIGN We compared 17 typical MCL cases with a homogeneous group of 13 untreated MALD1 cases (median follow-up, 71 months). We conducted gene expression profiling with functional analysis in five MCL and five MALD1. Results were validated in 12 MCL and 8 MALD1 additional cases by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and in 24 MCL and 13 MALD1 cases by flow cytometry. Classification and regression trees strategy was used to generate an algorithm based on CD38 and CD200 expression by flow cytometry. RESULTS We found 171 differentially expressed genes with enrichment of neoplastic behavior and cell proliferation signatures in MCL. Conversely, MALD1 was enriched in gene sets related to immune activation and inflammatory responses. CD38 and CD200 were differentially expressed between MCL and MALD1 and confirmed by flow cytometry (median CD38, 89% vs. 14%; median CD200, 0% vs. 24%, respectively). Assessment of both proteins allowed classifying 85% (11 of 13) of MALD1 cases whereas 15% remained unclassified. SOX11 expression by qRT-PCR was significantly different between MCL and MALD1 groups but did not improve the classification. CONCLUSION We show for the first time that MALD1, in contrast to MCL, is characterized by immune activation and driven by inflammatory cues. Assessment of CD38/CD200 by flow cytometry is useful to distinguish most cases of MALD1 from MCL in the clinical setting. MALD1 should be identified and segregated from the current MCL category to avoid overdiagnosis and unnecessary treatment.
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47
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Rojas SM, Díez-Campelo M, Luño E, Cabrero M, Pedro C, Calabuig M, Nomdedeu B, Cedena T, Arrizabalaga B, García M, Cerveró C, Collado R, Azaceta G, Ardanaz MT, Muñoz JA, Xicoy B, Rodríguez MJR, Bargay J, Morell MJA, Simiele A, del Cañizo C. Transfusion dependence development and disease evolution in patients with MDS and del(5q) and without transfusion needs at diagnosis. Leuk Res 2013; 38:304-9. [PMID: 24333115 DOI: 10.1016/j.leukres.2013.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Revised: 11/04/2013] [Accepted: 11/07/2013] [Indexed: 10/26/2022]
Abstract
Patients with isolated del(5q) and MDS are considered to have good prognosis as compared to other MDS subtypes. Most patients suffered of anemia and 50% of them required transfusions at diagnosis. It is known that for patients with MDS and del(5q) in transfusion dependence(TD), Lenalidomide is the first choice treatment. However, there are no data regarding natural evolution of anemia in patients diagnosed in MDS and del(5q) without TD, factors that may impact on the development of TD or disease outcome. In the present study we have performed a retrospective multicenter analysis on 83 patients with low-int 1 MDS and del(5q) without TD. During the study 61 patients became TD at a median of 1.7 years and only the Hb level 9 g/dL was associated with poorer TFS (p = 0.007) in the multivariate analysis. Among these 61 TD patients, 49 received treatment (19 Lenalidomide). Median follow up was 48 months, estimated OS at 2 and 5 year was 92% and 50% respectively. In the multivariate analysis for OS, platelets <100,000 mm(-3) and Lenalidomide treatment retained the statistical significant impact. LFS at 2 and 5 years was 86% and 73% respectively, and median time to sAML was 8.16 years (CI 95%: 6.05-10.27). In the multivariate analysis only thrombocytopenia retained statistical significance. In summary, this retrospective study show that level of Hb is an important parameter in order to determine the time until TD, it should be also stressed the importance of an early treatment in order to prevent TD development and shorter survival.
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48
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Puiggros A, Delgado J, Rodriguez-Vicente A, Collado R, Aventín A, Luño E, Grau J, Hernandez JÁ, Marugán I, Ardanaz M, González T, Valiente A, Osma M, Calasanz MJ, Sanzo C, Carrió A, Ortega M, Santacruz R, Abrisqueta P, Abella E, Bosch F, Carbonell F, Solé F, Hernández JM, Espinet B. Biallelic losses of 13q do not confer a poorer outcome in chronic lymphocytic leukaemia: analysis of 627 patients with isolated 13q deletion. Br J Haematol 2013; 163:47-54. [PMID: 23869550 DOI: 10.1111/bjh.12479] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 06/12/2013] [Indexed: 12/30/2022]
Abstract
Losses in 13q as a sole abnormality confer a good prognosis in chronic lymphocytic leukaemia (CLL). Nevertheless, its heterogeneity has been demonstrated and the clinical significance of biallelic 13q deletions remains controversial. We compared the clinico-biological characteristics of a series of 627 patients harbouring isolated 13q deletions by fluorescence in situ hybridization (FISH), either monoallelic (13q × 1), biallelic (13q × 2), or the coexistence of both clones (13qM). The most frequent 13q deletion was 13q × 1 (82·1%), while 13q × 2 and 13qM represented 8·6% and 9·3% of patients respectively. The median percentage of altered nuclei significantly differed across groups: 55%, 72·5% and 80% in 13q × 1, 13q × 2 and 13qM (P < 0·001). However, no significant differences in the clinical outcome among 13q groups were found. From 84 patients with sequential FISH studies, eight patients lost the remaining allele of 13q whereas none of them changed from 13q × 2 to the 13q × 1 group. The percentage of abnormal cells detected by FISH had a significant impact on the five-year cumulative incidence of treatment and the overall survival, 90% being the highest predictive power cut-off. In conclusion, loss of the remaining 13q allele is not enough to entail a worse prognosis in CLL. The presence of isolated 13q deletion can be risk-stratified according to the percentage of altered cells.
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49
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Costa D, Muñoz C, Carrió A, Nomdedeu M, Calvo X, Solé F, Luño E, Cervera J, Vallespí T, Berneaga D, Gómez C, Arias A, Such E, Sanz G, Grau J, Insunza A, Calasanz MJ, Ardañaz MT, Hernández JM, Azaceta G, Álvarez S, Sánchez J, Martín ML, Bargay J, Gómez V, Cervero CJ, Allegue MJ, Collado R, Campo E, Nomdedeu B. Reciprocal translocations in myelodysplastic syndromes and chronic myelomonocytic leukemias: Review of 5,654 patients with an evaluable karyotype. Genes Chromosomes Cancer 2013; 52:753-63. [DOI: 10.1002/gcc.22071] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 04/11/2013] [Indexed: 12/18/2022] Open
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50
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Santacreu DI, Collado R, Díaz L, Tormos M, García-Giménez J, Arrizabalaga B, Orero M, Pérez P, Ruiz M, Sancho-Tello R, Regadera A, Tormo M, Yagüe N, Egea M, O'Connor J, Sáez G, Carbonell F. P-232 Antioxidant system aberrations as response to generation of reactive oxygen species (ROS) in low/intermediate-1 risk myelodisplastic syndrome. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70279-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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